171 Collins St, Melbourne, Victoria, 3000, Australia

Application For Employment

Personal Information
Name

Address City State Zip

Phone Number Mobile Number Email Address

Are You A U.S. Citizen? Have You Ever Been Convicted Of A Felony?
Yes No Yes No

If Selected For Employment Are You Willing To Submit to a Pre-Employment Drug Screening Test?
Yes No

Position
Position You Are Applying For Available Start Date Desired Pay

Employment Desired
Full Time Part Time Seasonal/Temporary

Education
School Name Location Years Attended Degree Received Major

References
Name Title Company Phone

Employment History
Employer (1) Job Title Dates Employed

This job application form downloaded from BHP Group Limited

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (2) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (3) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (4) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Employer (5) Job Title Dates Employed

Work Phone Starting Pay Rate Ending Pay Rate

Address City State Zip

Signature Disclaimer
I certify that my answers are true and complete to the best of my knowledge.
If this application leads to employment, I understand that false or misleading information in my application or interview may
result in my release.

Name (Please Print) Signature

Date

This job application form downloaded from BHP Group Limited